Cognitive Interviewing Cracks Fraudulent Claims

It is accepted that insurance fraud goes on evenfact, offend the ordinary customers. At the
though it is an illegal practice. Is it seen ascompany in East Grinstead, they use psychological
vengeance against insurers' ever increasingtechniques as part of general conversations. "We
premiums, but who try hard to avoid paying outbuild up a rapport with the customer, which is
on claims when they come. Insurance fraud is agreat if they are genuine. It is also good if they
problem and costs an estimated £3 billionare not," said Gabrielle Ashley, founder of ACM
annually. The festive season is notoriously bad - inwith Bill Truemen, an ex fraud specialist at Lloyds
the New Year claims rise by 40% as theTSB and Direct Line.
over-spending at Christmas catches up.The first step is to compile a written 'virgin
The industry is not taking it any more, and, hasversion' of the case from a telephone
introduced techniques developed by the Unitedconversation with the claimant from the second
States police called 'Cognitive Interviewing'. It isthey discovered the problem up to contacting
used to expose lies of insurance cheats whomtheir insurers. Then they ask questions and probe
are unaware they are being questioned.various points to get different perspectives. Ms
A UK company based in East Grinstead, WestAshley said. "If you are telling the truth, it comes
Sussex, is pioneering the technique and they havefrom the filing cabinet left side of your brain. If
on board many top insurance companies. Whenyou are lying, it comes from the right side, and
their researchers communicate with claimantsyou change your language and the tenses you
they act as if they are the insurers so as not toare using,"
raise suspicions. They pride themselves in saving,Decisions to reject claims have only had a 1%
for every 100 cases, a sum of £37,000appeal rate and no-one has taken them to the
and as we know, fraudulent claims are worth ainsurance ombudsman or to court despite having
lot of money each year - 15% of all favourabledealt with over 3,500 cases.
claims, so if the whole industry used this techniqueOther insurance companies are developing their
they could make huge savings.own versions of cognitive interviewing. But some
The £3bn is largely claimed on motorcompanies remain sceptical about these methods.
insurance policies; most suspicious are fire damageNorwich Union does not consider any one fraud
claims, and unusual travel and homes claims.detection system in isolation to be a 'silver bullet'.
Ultimately, the submitting of dishonest claimsThey adopt a layered approach, combining a
directly effects all policy holders and theirframework of manual and technology-based
premiums go up.controls. As part of this, they seek to balance the
Latterly, insurers relied on the covert use of lietwin goals of enhanced fraud savings with
detectors when dealing with telephone claims butminimum impact on their genuine customers in
also worried that stringent questioning might, interms of delay or other inconvenience.